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Form Approved..
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<br />PERMITTEE NAME/ADDRESS (lneYlrF«~fNryN~Loeular Uoldw+nr)
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<br />NATIONAL POLLUTANT OISCHAROE ELIMINATION SYSTEM_ JNPDESI OMB No. 2040-000
<br />DISCHARGE MONITORING REPORT /D Rl (~ T ~[~~
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<br />PARAMETER QUANTITY OR LOADING 4UALITY OR CONCENTRATION NO. FREOUENCV
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<br />..~{ 1 am aware that there are sl~nlflunt pendHe for submlttlnE hbe Information, d1 Y
<br />pEp OR PRINTED Indudin[ the posdbllity of ene and Imprisonment for knowing eldaUom. OFFICER OR AUTHORIZED AGENT CODE NUMBER YEAR MO DA
<br />COMMENTS ANO EXPLANATION OF ANY vIVLA r IvNS /Rel~nnc~ sn •rracnm~nrs n~r~!
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<br />EPA Form 3320-1 (Rev. 399) Previous editions maybe used. ~~~~~ ~. ~T~{1l ~ ~4-~gi(p, AGE ~ ~
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